The Beauty of Ratios: A New and Simple Guide to Healthful Eating

We need to stop thinking about the individual ingredients -- eat more of this, eat less of that -- and instead focus on getting a complete diet

One of the books no serious kitchen should be without is Michael Ruhlman's Ratios: The Simple Codes Behind the Craft of Everyday Cooking. In it, Ruhlman gets beyond the need for memorizing complicated recipes by enlightening us on the way things really work. They function in a ratio, a relationship that produces harmony and results in delicious food. In medicine, we apply that ratio principle to every decision we make for a patient. We call it a risk/benefit analysis. There is not a single perturbation to the human system that is not without some consequence; It is always a matter of managing a ratio of the risks and benefits.

We've been told we eat too many carbohydrates, but we consume about the same amount as we did in the early 20th century.

A simple pie crust is literally as easy as 1-2-3: One part sugar, two parts fat, three parts flour. Forget the measurements and focus on the ratio, the relationships; if you focus on the sugar and the pie dough seems dependent upon only this one variable. In examining our understanding of how what we consume affects our being, we run the risk of focusing on extremes, on single variables, at the expense of understanding the context in which they operate.

A simple example is the current schizophrenic approach to carbohydrates. There is advice to consume more carbohydrates in place of fats. There is advice to consume fewer carbohydrates, consume more whole grains, avoid grains all together, consume more carbohydrates but less gluten, eat less 'bad' carbohydrates and more 'good' carbohydrates -- however those are defined -- and every permutation spanning the entire gamut of possibilities. We have been told we eat too many carbohydrates and that is why we are obese and ill. The fact is that we consume about the same amount of carbohydrates as we did in the early 20th century, when the incidence and prevalence of these disease states were a fraction of what they are now. The difference is in the ratio of refined carbohydrates to whole grains (with a corresponding approximately 25 percent reduction in fiber).

Similar data is coming to light regarding the consumption of meat, specifically red meat. Multiple studies have failed to demonstrate a significant correlation between moderate consumption of fresh red meat and cardiovascular disease. One such study examined the Inuit paradox, in which it was noted that in the diet of the native Inuit people there was limited vegetable and carbohydrate consumption but very high levels of protein and fat consumption. Yet despite this, there was very little cardiovascular disease. However, the diet of the Inuit people was very high in omega-3 polyunsaturated fatty acids (PUFAs) and substantially lower in omega-6 PUFA.

Analysis of the diet of hunter-gather tribes, which subsist on wild game, reflect significantly lower omega-6 to omega-3 ratios than that the typical western diet, which is anywhere from 14 to 25. The incidence and prevalence of cardiovascular disease, obesity, and diabetes among hunter-gatherers is likewise substantially lower. As recently as two hundred years ago, before the industrialization that has resulted in our modern grain-fed feedlot cattle, the meat in our diet reflected the lower omega-6 to omega-3 ratio seen in diets associated with low rates of obesity, diabetes, and cardiovascular disease like the Inuit and Mediterranean diets.

Still, several of these self-same studies have demonstrated a correlation between the aforementioned disease states and processed meat consumption. The key may lie in the ratio of sodium to potassium. Despite a large public program to decrease sodium consumption, the actual data linking high sodium levels to cardiovascular disease remains "weak and inconsistent," according to Dr. Salim Yusef, an expert in clinical epidemiology and biostatistics. A recent study sheds light on this complex relationship, noting that when the sodium to potassium ratio exceeded one in trials, the cardiovascular risk increased; as the ratio decreased to less than one, the risk decreased. As noted by the study authors, a 100 g (about 3 ½ ounces) serving of natural, wholesome pork contains roughly 60 mg of sodium and about 340 mg of potassium. But if you process that meat into the average deli ham, you end up with 920 mg of sodium and only 240 mg of potassium.

Nature rarely deals in absolutes. She is about balance and harmony. In beginning to understand the relationships and ratios that exist in nature, we can begin to balance the demands of our modern world with the demands of our natural bodies.

Michael S. Fenster is an interventional cardiologist and professional chef. He is currently working on a new television show, Code Delicious, and his book, Eating Well, Living Better, will be published in early 2012. Visit his website.